American Medical Association Family Medical Guide - American Medical Association [409]
Fungal Diseases of the Lungs
Several diseases that infect the lungs can result from breathing in fungal spores. These fungal infections are contracted primarily by inhaling the spores (usually found in soil) from bird or bat droppings or from decaying plant matter such as old wood or dead leaves. The diseases are named for the fungus that causes them. For example, aspergillosis is caused by a species of the fungus Aspergillus, blastomycosis by Blastomyces dermatitidis, coccidioidomycosis by Coccidioides immitis, cryptococcosis by Cryptococcus neoformans, and histoplasmosis by Histoplasma capsulatum. In healthy people, the immune system destroys the spores. However, in some people (usually people who have an impaired immune system or who are very old or very young), the fungal infection can spread throughout the body in the bloodstream and become life-threatening.
Symptoms
Many fungal diseases of the lungs begin with mild, chronic, flulike symptoms such as fever with chills, coughing, chest pain, and muscle aches, but may progress to symptoms of pneumonia (see page 660) such as wheezing or difficulty breathing. Some fungal diseases of the lungs can cause other respiratory disorders, such as allergies (see page 912) or asthma (see page 640). Some may cause skin reactions such as a rash (coccidioidomycosis), skin lesions (blastomycosis), or mouth ulcers (histoplasmosis) in addition to respiratory symptoms. Cryptococcosis may not cause symptoms or may cause weight loss, night sweats, and meningitis (see page 692) in addition to flulike symptoms. See your doctor immediately if you have any symptoms of a fungal infection in your lungs.
Diagnosis
To diagnose a fungal infection in your lungs, your doctor will examine you and listen to your lungs with a stethoscope. In addition, he or she may order blood tests and test samples of your phlegm, urine, or spinal fluid to determine if you have a fungal infection. For a definite diagnosis, you may have a bronchoscopy (see previous page).
Treatment
Fungal diseases sometimes clear up on their own without treatment. If your symptoms are mild, your doctor may prescribe an oral antifungal medication. However, if your symptoms are severe or if you are susceptible to infection because your immune system is weakened, your doctor will probably administer an antifungal medication intravenously (through a vein).
Legionnaires’ Disease
Legionnaires’ disease is a potentially serious form of pneumonia (see page 660) caused by a bacterium that breeds in warm, moist environments, usually water and air-conditioning systems. Infection can occur when a person inhales droplets of contaminated water. Older people, smokers, people who have lung disorders, and people with an impaired immune system are most susceptible to infection, and some can die of the infection. Young, healthy people generally recover fully.
Symptoms
The symptoms of Legionnaires’ disease develop about a week after exposure to the bacterium and include fever with chills, headache, muscle aches, chest pain, coughing, abdominal pain, nausea and vomiting, and diarrhea.
Diagnosis
Your doctor can determine if you have Legionnaires’ disease by testing samples of phlegm and urine for the presence of the disease-causing bacterium.
Treatment
Usually a person with Legionnaires’ disease is given antibiotics intravenously (through a vein) in a hospital. Young, healthy people may be treated on an outpatient basis.
Tuberculosis
Tuberculosis (TB) is a contagious disease caused by a bacterium that can be contracted when a person inhales infected droplets coughed or